Da Rin G, Amici G, Virga G, Bardin C, Calzavara P, Bocci C
Clinical Chemistry Institute, Regional Hospital S. Maria dei Battuti, Treviso, Italy.
Am J Nephrol. 1995;15(6):480-7. doi: 10.1159/000168890.
Overestimation of creatinine measurement using the Jaffé kinetic method in peritoneal dialysis solutions, due to glucose interference, has been quantified and corrected through the elaboration of linear formulas obtained from 110 recovery and 301 biological tests. The added pure powdered creatinine and enzymatic method were considered as references after proven accuracy. Considering creatinine as well as glucose concentration interference, we obtained correction formulas from multiple regression application. All the computed formulas gave satisfactory corrections but different accuracy levels. The best model in biological samples was: Corrected CR = K1JafféCr + K2Glucose (all values in mg/dl) where K1 = 0.973 and K2 = -0.00035 (Rsq = 0.987, F ratio = 10,945, p = 0.00001). Applying formulas to biological samples there was a drop in accuracy, possibly explained by the presence of numerous unidentified substances in peritoneal dialysis biological samples that can amplify scatter. Every laboratory can reduce the error of the Jaffé kinetic assay by calculating their own correction formula in relation to the method and instrument used, because Jaffé kinetic assay gives different results with different kinetic windows. So, especially when applied to peritoneal dialysis fluid measurements, if a creatinine assay reference method is not available, the correction formula can be applied directly as given. Otherwise the method we have described can be followed with a well-structured creatinine recovery fest to identify and quantify assay interferences.
由于葡萄糖干扰,使用Jaffé动力学方法测量腹膜透析液中的肌酐会出现高估情况。通过对110次回收率测试和301次生物学测试得到的线性公式进行精心推导,已对这种高估进行了量化和校正。在证实准确性后,添加的纯肌酐粉末和酶法被视为参考方法。考虑到肌酐以及葡萄糖浓度的干扰,我们通过多元回归应用获得了校正公式。所有计算出的公式都给出了令人满意的校正结果,但准确性水平不同。生物样本中的最佳模型为:校正后的肌酐(Corrected CR)= K1×Jaffé法测得的肌酐 + K2×葡萄糖(所有值的单位均为mg/dl),其中K1 = 0.973,K2 = -0.00035(决定系数Rsq = 0.987,F值 = 10945,p = 0.00001)。将公式应用于生物样本时,准确性有所下降,这可能是由于腹膜透析生物样本中存在大量未知物质,这些物质会放大离散度所致。每个实验室都可以通过根据所使用的方法和仪器计算自己的校正公式来减少Jaffé动力学测定的误差,因为Jaffé动力学测定在不同的动力学窗口下会给出不同的结果。因此,特别是在应用于腹膜透析液测量时,如果没有肌酐测定的参考方法,可以直接应用给定的校正公式。否则,可以按照我们所描述的方法,通过精心设计的肌酐回收率测试来识别和量化测定干扰。